[Histonet] problem with 88305 reimbursement

[Cynthia Pyse]

It's not a SNF but an actual hospital. These are outpatient that go to the
hospital for any service. Example, one patient went to a clinic for a
vaccination, another went for blood work. None of which has anything to do
with the biopsy from the doctor's office.

Cindy Pyse, CLT, HT (ASCP)
Laboratory Manager
X-Cell Laboratories
20 Northpointe Parkway Suite 100
Amherst, NY 14228
716-250-9235 etx. 232
e-mail cpyse <@t> x-celllab.com

-----Original Message-----
From: Brendal Finlay [mailto:brendal.finlay <@t> medicalcenterclinic.com] 
Sent: Tuesday, January 29, 2013 2:32 PM
To: Cynthia Pyse
Cc: <histonet <@t> lists.utsouthwestern.edu>
Subject: Re: [Histonet] problem with 88305 reimbursement

Is it a skilled nursing facility?  If a patient is in an SNF (for rehab or
other reasons) then Medicare will not pay. The testing facility has to
contract with the SNF for payment. I have not seen this with a hospital,
though. 

Brendal Finlay, HT (ASCP)

On Jan 29, 2013, at 12:51 PM, "Cynthia Pyse" <cpyse <@t> x-celllab.com> wrote:

> Hi Histonetters
> 
> We are currently having a problem with our Medicare reimbursement on 
> the tech component of the 88305. If the patient has been seen at a 
> hospital, either in-patient or out- patient, we are told by Medicare 
> that we have to contract with that hospital to bill for the 88305. The 
> biopsy was not done at the hospital but in a doctor's office. 
> According to Medicare if there the same date of service it can only be 
> billed through the hospital. Medicare is calling it consolidated 
> billing. I can't see how the hospital can bill for something that was 
> done in the doctor's office then sent to an independent lab. Is anyone 
> else having this problem? How are you handling it with Medicare? Any 
> help would be appreciated. Thanks in advance
> 
> Cindy
> 
> 
> 
> 
> 
> Cindy Pyse, CLT, HT (ASCP)
> 
> Laboratory Manager
> 
> X-Cell Laboratories
> 
> 20 Northpointe Parkway Suite 100
> 
> Amherst, NY 14228
> 
> 716-250-9235 etx. 232
> 
> e-mail cpyse <@t> x-celllab.com
> 
> 
> 
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